Advances in breast cancer treatment: the emerging role of ixabepilone.

Although taxanes and anthracyclines have dramatically improved the treatment of breast cancer, resistance to these agents upon continued exposure is almost inevitable. The epothilone ixabepilone was US FDA approved in 2007 based on its demonstrated activity in metastatic breast cancer that is resistant to other approved agents, including taxanes and anthracyclines. Over 2000 patients have now received this agent in clinical trials, clarifying that ixabepilone has efficacy in minimally and heavily pretreated patients and can overcome chemotherapy-induced drug resistance, while maintaining a manageable safety profile. These clinical trials identified a progression-free survival advantage with ixabepilone/capecitabine combination therapy over capecitabine monotherapy. Moreover, certain hard-to-treat subgroups of patients may derive additional benefit from ixabepilone therapy. The objective of this report is to review the updated body of ixabepilone clinical data in breast cancer, as well as key considerations for ixabepilone administration and side-effect management.